Ugh. Overwhelmed and super sad

Our vet suspected acromegaly from the moment Hamilton was diagnosed. However, I thought, ignorantly, we dodged that bullet because we were able to regulate him on 2 units of Lantus. Just before Christmas we lost regulation and he continued to climb. We are up to 5.5u of Lantus and he’s showing some better numbers, but I’m starting to come out of denial about the acromegaly.

Our vet didn’t seem to support getting the actual diagnosis because our treatment plan would be the same due to Hamilton’s age, heart issues, and kidney disease. He was quite confident about acromegaly as he’s seen it before.

Unfortunately, Hamilton has started to cower and hiss at his injections, so I’m going to ask about switching to Levemir (as someone here just told me about it). I’m overwhelmed, exhausted, and feeling a bit pessimistic about our options.

I’d be happy to hear thoughts about possible avenues for our sweet boy.

Gizmo also has Acro. He was diagnosed with diabetes last Feb and Acro in Sept. We decided to try treating with cabergoline. He is just finishing his 4th month of it. I plan on getting his IGF-1 numbers retested to see if it is helping, but I believe that it is (could just be me holding onto hope though!).

Neko sometimes walked away while I was shooting Lantus, she purred through her Levemir shots. I think you've got a good case to switch.

I would still suggest getting the IGF-1 test done. If you do want to think about using cabergoline, I'd want a confirmed positive results before starting it. It's good your vet has seen acromegaly. Most vets think they haven't, but the latest research shows one in four diabetics has it, so most vets have seen acros, whether or not they know it. The IAA (insulin auto antibody) test is also a good one. A fair number of acros have it too. Most vets dismiss it's importance, but if a cat does have IAA, it's supposed to be self limitiing after about a year and knowing you are dealing with IAA helps dosing decisions.

Not everyone pursues treatments with acromegaly. Most cost money and/or time/travel that not everyone can do. Cabergoline is the only one that is within most people's pocketbook. Results are mixed, but even lowering the dose and growth hormone output somewhat would be a win to me. We have had many people treat acrocats with just as much insulin they need and treating any other conditions that arise. Life spans are variable, but we've had a couple go four years. And some that get taken by something totally unrelated to acromegaly.

Where do you live? That might help me describe other treatment options if some are near you. Any other treatment places would also want to see the IGF-1 number.

University of Florida - Health has a Cyberknife unit, like SRT but even more precise. Check here and the locations tab. Cyberknife is relatively new. I only know of one cat that has had it (in Yonkers) and that cat went off insulin. It is spendy. And I don't know if they do pets in U of F. I had heard they had a SRT machine somewhere too. Your vet may know or be able to find out.

I drove from Vancouver to Fort Collins with Neko - 3 days each way.

This post from a couple years ago listed some options in North America. Including a post from @Karen & Lily who is in Florida. She may have done some research.

After hearing a $6k quote for SRT, I realize that option is just not doable for us. I am struggling with guilt. Though, at age 15, with his heart condition and kidney disease advancing, I truly wonder how much benefit he would gain.

I am going to talk to our vet about the blood test and potential for using cabergoline. I hate that we’re in a position where $$$ has to be a factor.

Does anyone have a good picture of realistic expectations for us? I want to make sure 1) I am prepared for what we might encounter and 2) What potential Hamilton has for encountering pain and suffering along the way. What do I need to keep an eye out for?

Oh I hate this so much. I’ve always been the “whatever they need” pet parent, but we have yet to find the darn money tree.

SRT was a lot cheaper when I was faced with the decision - and the Canadian dollare was more favourable then too. It would be a hard decision now.

As for what to expect, it's really hard to say. Each cat is different. I've seen one kitty pass at age 19, 4 years after their acro diagnosis with the only treatment being as much insulin as he needed. That's probably the long end of the life span I'd expect. The kidneys and the heart are two you have to keep on top of. Sounds like you already have those on the radar. I'd keep on regular heart check ups and do an echocardiogram if you haven't already. A lot of our acros get arthritis. Neko's was quite bad. She was on supplements for it, and got acupuncture and buprenorphine for the pain. The buprenorphine was a game changer for her when it got to the point she needed it. A number of the acros get GI issues. Jeff's Leo and my girl had small cell lymphoma - which is fairly treatable. I've seen a number with pancreatitis, so learn about it and the treatments. There is a good write up in the Health Links forum.